淋巴瘤患者HBV感染标志物及其DNA定量的实验室调查与分析  

The Investigation Study of HBV Infection Markers and HBV DNA Quantitation in Patients with Lymphoma

作　　者：黄英[1] 许晓跃[2] 左向华[2] 金欣[2] 陈水平[2] 陈建魁[2] 

机构地区：[1]军事医学科学院门诊部,北京100850 [2]军事医学科学院附属医院检验科,北京100071

出　　处：《标记免疫分析与临床》2018年第1期8-12,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨霍奇金淋巴瘤、非霍奇金淋巴瘤、弥漫性大B细胞淋巴瘤和T淋巴母细胞淋巴瘤患者HBV感染标志物和HBV DNA的表达情况。方法选取近5年淋巴瘤科1779例住院病人,其中霍奇金淋巴瘤(Hodgkin's lymphoma,HL)160例,非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL)1590例,弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)16例,T淋巴母细胞淋巴瘤(T cell lymphoblasts lymphoma,T-LBL)13例。健康查体者作为正常对照组(normal control group,NCG),共12890名,男性8450名,女性4440名。采用电化学发光法测定乙型肝炎病毒抗原和抗体;采用Taq Man实时荧光定量PCR方法测定乙型肝炎病毒DNA。结果霍奇金淋巴瘤、非霍奇金淋巴瘤、弥漫性大B细胞淋巴瘤和T淋巴母细胞淋巴瘤的HBsAg、HBeAg的阳性率高于显著高于正常对照组;霍奇金淋巴瘤和非霍奇金淋巴瘤的HBcAb阳性率显著高于正常对照组;霍奇金淋巴瘤、非霍奇金淋巴瘤和弥漫性大B细胞淋巴瘤的HBsAb阳性率低于正常对照组;说明HBV携带者对HBV的免疫力较低,发生恶性淋巴瘤的风险较大。乙型肝炎病毒具有嗜淋巴细胞和嗜肝细胞的特性,淋巴瘤患者HBsAg携带率是正常对照组的4.1~10.9倍;霍奇金淋巴瘤和非霍奇金淋巴瘤患者HBV DNA的阳性率是正常对照组的2.2~8.3倍。结论 HBV感染与淋巴瘤的发生具有很强的相关性,患者血清的HBV抗原、抗体和DNA水平可能是淋巴瘤患者致病和HBV再激活的重要因素。对于用化疗药物或免疫抑制剂治疗的淋巴瘤患者,应定期对其肝功能和乙肝标志物进行检测。若出现肝功异常或HBV再激活等情况,应立即评估患者病情,及时调整治疗方案。Objective To investigate the expression of HBV infection markers and HBV DNA in patients with Hodgkin＇s lymphoma, non-Hodgkin＇s lymphoma, diffuse large B-cell lymphoma and T cell lymphoblastic lymphoma. Methods A total of 1779 patients who were treated in our hospital in the last 5 years were enrolled in the study, including 160 patients with Hodgkin＇ s lymphoma （HL）, 1590 non-Hodgkin＇ s lymphoma （NHL） , 16 cases of Diffuse Large B Cell Lymphoma （DLBCL）, and 13 cases of T lymphocyte lymphoma （T-LBL）. The normal control group includes 12,890 people which is consists of 8450 male and 4440 female. Hepatitis B virus antigen and antibody were determined by electrochemiluminescence method. Hepatitis B virus DNA was determined by TaqMan real-time fluorescence quantitative PCR. Results The positive rates of HBsAg and HBeAg in Hodgkin＇s lymphoma, non-Hodgkin＇s lymphoma, diffuse large B-cell lymphoma and T lymphoblastic lymphoma were significantly higher than those in the normal control group. The positive rate of HBcAb in Hodgkin＇s lymphoma and non-Hodgkin＇s lymphoma were significantly higher than those in the normal control group. The positive rate of HBsAb in Hodgkin＇s lymphoma, non-Hodgkin＇s lymphoma and diffuse large B-cell lymphoma were lower than those in the normal control group. The immunity of HBV carrying people is lower than the normal control group. The risk of developing malignant lymphoma is higher than the normal control group. Hepatitis B virus has lymphatic and hepatocyte characteristics. HBsAg carrying rate of lymphoma patients is 4.1 to 10.9 times higher than that of the normal control group. The positive rate of HBV DNA in patients with Hodgkin＇s lymphoma and non-Hodgkin＇s lymphoma was 2.2 to 8.3 times higher than that in the normal control group. Conclusion HBV infection is strongly correlated with the occurrence of lymphoma. HBV antigen, antibody and DNA level might be an important factor in lymphoma pathogenesis and HBV reactivation in the lymphoma patients. F

关 键 词：淋巴瘤 乙型肝炎病毒 感染标志物 DNA定量 

分 类 号：R512.62[医药卫生—内科学] R733.1[医药卫生—临床医学]